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Friday, August 14, 2020
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An innovative way to meet your patient’s nutritional needs

This one-of-a-kind testing solution does what a simple blood test cannot – ensure that your patient’s unique nutritional needs are met.

The health of dogs and cats starts with the quality of food they eat. As this becomes general knowledge, more vets are striving to educate their clients on the importance of diet for general wellness, and for the management of acute diseases. Unfortunately, countless commercial diets are still inadequate in many of the essential vitamins and minerals required for companion animals to thrive. While regular blood tests are a great way to keep on top of your patients’ nutritional needs, there’s a new testing solution available that takes this a step further.

The vitamin D example

Vitamin D is a perfect example of a nutrient that many animals lack. As one of the essential vitamins, it’s only obtained through the cat or dog’s diet. Some diets are certainly better than others, but in general are cats and dogs getting enough?

A study out of Tufts University aimed to determine how food source and supplements affect 25(OH)D concentrations, the storage form of vitD. Serum was collected from clinically healthy dogs, and pet parents were surveyed about food source and supplements. Serum 25(OH)D concentration was measured using a quantitative chemiluminescent assay (LIASON, DiaSorin, Stillwater, MN). Results revealed that a wide range of pet food brands were insufficient in providing adequate Vitamin D.

The case for testing

Although AAFCO standards indicate and regulate Vitamin D3 added to food, the primary source of Vitamin D comes from the protein source and that can vary widely. Testing is required to see what the actual biologically available Vitamin D concentration is in a particular pet. As the study above demonstrates, many pets are found to be insufficient.

The body is a finely tuned machine with vitamins and hormones existing in a delicate balance. Too little and problems can develop. Too much and other problems can arise. In order to help your clients manage their animals’ diets and essential vitamin levels, testing is required to determine proper dosing. Since every animal is different, there is no “one-size-fits-all” approach to supplementing essential vitamins.

A simple blood test can tell you the status of any particular nutrient in the body. But an innovative new service from VDI Labs takes this one step further by offering a secondary value: patient-specific dosing guidelines. Dosing guidelines are unique to the patient and are intended to aid in the process of recommending supplements to clients.

Testing with VDI Laboratory

Known as the “Test & Treat Solution”, this low-cost, convenient practice for managing essential vitamin levels makes meeting your patients’ nutritional needs – and correcting nutritional deficiencies – easier than ever. Once levels are determined via blood tests, the lab report goes on to provide patient specific dosing requirements and then converts those to a recommended supplement that has known efficacy. VDI Lab offers test and treat solutions for three critical essential vitamins: Vitamin D, B12 (Cobalamin), and magnesium.

Patient Specific Dosing Guidelines take into account multiple factors of the patient to develop a targeted dose range. The goal is to reach sufficiency with supplementation on the first try.
Once the dose range is established, the doses are then converted to a recommended supplement that has known efficacy.

To learn more, visit vdilab.com.

Supporting heart health in dogs and cats through diet

You can support your patients’ heart health with a deeper understanding of which foods, herbs and supplements help this vital organ thrive.

The different parts of a dog or cat’s body must function well together in order to keep him healthy. As veterinarians, we know that each piece of a patient’s miraculous puzzle plays a role in his vibrant, active, happy, and hopefully long life. Heart health is one of the most critically important pieces of this puzzle, and the best way to promote it is to gain a better understanding of how diet plays a role in its function.

Nutrition and heart health

Macronutrients

As a specialized muscle, the heart requires excellent and bioavailable amino acids in the diet to build proteins and keep the constantly beating muscle cells healthy. This means the patient’s food must contain appropriate levels of essential amino acids – ten for a dog, and 11 for a cat.

We know that carnivorous pets need excellent proteins and balanced amino acids from meat sources to maintain their natural health. It makes sense that a carnivore’s heart health is adapted to what nature provides: excellent quality meat. The legume proteins used in grain-free diets are not as complete as meat proteins for carnivores. They lack certain amino acids like taurine, which is essential to the heart and its function. Although taurine is not considered an essential amino acid for dogs as it is for cats, improving deficiencies helps support heart function.

Weight gain and cardiac disease are more likely associated with a high carbohydrate diet rather than one high in fat. Feeding an ancestrally appropriate diet (e.g. low carbohydrate, and meat protein with moderate fat) can help animals maintain a heart-healthy weight.

Herbs

The heart’s quality of function is affected both by the clarity of nerve signaling throughout the muscle tissue and the vascular tone as it pumps blood. Vascular elasticity then affects the efficiency of the muscular contractions. These components can be supported with herbs historically known to support normal cardiac contractility, nerve signal transmission, and vascular elasticity.

Hawthorn berry, for example, has been effectively used to support cardiac function on several fronts. It has free radical scavengers, bioflavonoids, and other helpful components such as proanthocyanidin. Components in this herb may influence the strength of the heart’s contractions, widen the blood vessels (vasorelaxant), and increase the transmission of nerve signals throughout the heart.

Other herbs that are slightly diuretic, like dandelion, may also be supportive for the heart because they gently decrease the volume of blood passing through the heart pump.

Vitamins and minerals

Antioxidants and anti-inflammatory compounds from fresh unprocessed foods can help the heart heal from damage.

  • Vitamin E has been shown to maintain heart health and support normal healing after an injury.
  • Other supplements like coenzyme Q10 (a cofactor in the generation of adenosine triphosphate for energy) can enhance the efficiency of muscle and valve function; CoQ10 thus helps optimize the energetic state of the heart.7
  • Magnesium is important for cardiovascular hemodynamics and electrophysiologic functioning. Animals with chronic gastrointestinal issues, diarrhea, kidney disease, or who eat processed pet foods can develop electrolyte deficiencies, especially in magnesium. These deficiencies can compromise heart function. Safely supplementing important electrolytes such as magnesium can help maintain healthy cardiac function over time.

NOW® Pets Cardiovascular Support – an all-in-one solution

NOW® Pets Cardiovascular Support is the product I recommend for patients who would benefit from cardiovascular support. Designed to support normal circulation and overall heart health in both dogs and cats, it is a unique pet supplement made with high-quality, functional ingredients such as carnitine, taurine, antioxidants, and botanicals to overall support a healthy cardiovascular system. NOW® Pets formulates its premium pet supplements with the same attention to quality and detail put into supplements intended for humans.

The comprehensive NOW® Pets Cardiovascular Support formula contains:

  • Pharmaceutical grade CoQ10 , a safe antioxidant that has been studied extensively for possible use in managing coronary heart disease.
  • A non-GMO Vitamin E (d-alpha Tocopheryl), which preserves cardiac function by reducing oxidative stress.
  • L-Carnitine, an amino acid that supports heart health in breeds that are prone to cardiac stress
  • Taurine, an amino acid that in recent studies have shown that a taurine deficiency is one cause of a heart condition called dilated cardiomyopathy (DCM)  in cats and now for dogs.
  • Low Magnesium levels has been linked with cardiovascular risk factors.
  • Hawthorn an herb, has had multiple clinical trials and found to improve blood circulation to the ventricles of the heart specifically. Also studies have found hawthorn to be effective for early stage congestive heart failure.
  • Organic Dandelion Root, rich in potassium and naturally contains Vitamin A, C, K, D and B-complex

If we focus on the dietary factors necessary for heart health, we can protect and enrich the quality of our patients’ lives.

NOW Foods (Bottom Banner)

Tape: a valuable item in the veterinary toolbox

As a qualified veterinarian, I work primarily with horses in my practice. Among the many valuable items in my veterinary toolbox is tape. I often get questions and requests for assistance with other animals besides horses, so I have used the elastic taping skills from my training with large animals to develop some principles for dogs.

Whether working with humans, horses or small mammals, the general concepts for using tape remain similar. We utilize tape in many ways – for cases of chronic or acute pain; postural control and biomechanics; circulatory and lymphatic conditions; injuries and protection of tendons, ligaments and joints; conditions of fascia and scarring; and for seeking muscular homeostasis. Elastic taping shows both immediate and long-term effects, either solving the issue up front or increasing patient compliance for further care (we know that patient compliance is always going to be an issue).

In general, taping is an adjunct therapy that may be used in conjunction with other techniques such as cryotherapy, hydrotherapy, chiropractic, acupuncture, electrotherapy and micro-physiotherapy (figure 1). The tape may be applied over the animal’s coat if it is not too heavy (figure 2). For some lymphatic and pain control applications, it might be advisable to shave the treatment area, although this is less of an issue with newer canine-specific tape. In any case, it is important to use the correct tension (stretch) and application methodology, and the hair should be very clean.

Figure 1 and 2

Figure 3 and 4

Taping works through the endogenous analgesic system (figure 3). We look for a variety of results: we may modulate pain by bandaging through the skin and adjacent tissues; we may apply compressive and decompressive forces to control the pain message; and we may improve communication of the sensory-motor cortex, thus inhibiting the recognition of pain. For the circulatory/lymphatic system, the tape acts on the skin via its elastic effect (figure 4). This can promote movement between tissues, assist in self-regulation of interstitial fluid, normalize temperature and provide objective control of pain, edema and bruising.

One simple muscular technique, as an example, would be facilitation of the gluteus area. This taping might address both gait and pain issues as part of a program of care (figure 5). First, measure a length of tape in the area shown. Begin the application by anchoring the unstretched end of the tape strip on the upper pelvis (figure 6). Apply with moderate stretch, no more than 35% (figure 7). Finish on the femoropatellar joint with no stretch at the very end (figure 8). This application is designed to encourage movement in the affected area (figure 9). Taping exampleIf your patient assessment indicates that it is better to discourage movement in that muscle group, here is an alternative: you can modify the above application by reversing the tape direction; anchor at the joint and draw the tape upwards.

Education in proper taping techniques will enable many happy outcomes for canine patients. With the advent of new canine tape, we foresee even greater results! For tape options and infromation visit Kinesio Canine.

New painless insulin injections for diabetic pets!

This innovative easy-to-use device will deliver pain-free insulin injections to dogs and cats with diabetes. Here’s how you can invest in this game-changing new technology.

Diabetes affects nearly one million dogs and cats in North America, and these animals require an average of two injections a day. Compliance from clients is crucial so diabetic pets stay healthy, but many clients face emotional and physical difficulties giving a dog or cat painful insulin injections with common syringes – syringes which really haven’t altered significantly in nearly 170 years.

Now all that is about to change. PKA SoftTouch Inc. has been working on an innovative pain-free, pre-filled insulin injection device that will deliver virtually pain-free injections. With your help, the company is advancing towards veterinary clinical trials and the device is expected to be on the market by the end of 2020.

Old technology vs. PKA SoftTouch

As every veterinarian knows, using a traditional syringe is a multi-step process requiring two hands. First, the correct dosage must be pulled from the vial of medication. Then the practitioner or client must find an area with loose skin on the dog or cat, and, after pulling that section of skin between their fingers, they insert insert the needle, taking care to not inject it through their own skin and into their fingers. Next, the plunger is pulled back slightly; if blood is seen, the needle must be removed and re-inserted. Finally, once the injection process is finished, the cat or dog must be checked to ensure there is no blood or medication leaking from the injection site.

Now imagine a process that allows a client to pet the dog or cat with one hand, while giving him an injection he doesn’t even notice with the other hand. That would never happen with an outmoded syringe! Here’s why:

How to use the PKA SoftTouch alternative

  1. Remove the prefilled device from the sterile package.
  2. Detach the safety cap that prevents accidental actuation.
  3. Place the device against any area where there’s skin, like a tummy that’s being rubbed.
  4. Press the plunger – the medication is delivered painlessly in 1 to 1.5 seconds while your dog or cat continues to enjoy his belly rubs.
  5. Replace the safety cap and toss the device in any trash receptacle – no sharps disposal required!

Why is PKA SoftTouch pain-free?

How does the PKA SoftTouch work without causing pain? Unlike a traditional needle that reaches the nerves (Figure 1), this microneedle penetrates only 1.5 mm into the skin layer (see Figure 2), and injects the medication into the interstitial fluid, so it causes no pain. In addition, the drug reaches its therapeutic level twice as fast as when injected by a syringe (see Figure 3). After the injection, the needle automatically retracts back inside the device, and with a pull of the plunger, locks safely in place inside the microneedle device.

As PKA SoftTouch moves into its veterinary clinical trials, the company is currently running an “Equity Crowdfunding Campaign”. This campaign will allow the company to raise funds in order to move forward – the investor also gets shares and becomes a part owner in the program. To find out more, visit the equity campaign page at https://frontfundr.com/company/pka or the company website at www.pkasofttouch.com.

Once veterinary trials are completed, PKA SoftTouch will move on to human clinical trials, and then the worldwide market. The company strongly believes their device would also be the perfect vehicle to deliver the COVID-19 vaccine once it’s developed; since it’s pre-filled, pain-free and easy to use, with no need for sharps disposal.

The PKA SoftTouch technology will be a real disrupter in the syringe market.  Don’t miss your chance to get on board!

7 tips for creating a mindful practice culture

Some of the greatest lessons we can learn come from our patients. We explore how you can create a mindful practice culture within your clinic.

Pets and people are connected. I don’t think we realize how much we affect our animals by our presence, personality, and daily routines. Or wait…maybe it’s the other way around. Do we realize how much our animals can affect and teach us? Some of the greatest lessons I have learned have come from my pets. Whether it’s to slow down, be present, drink more water, or play more, the tips for creating a mindful practice culture can come from animal teachers.

Being mindful – pausing to breathe, notice, and pay attention to the present moment is perhaps the hardest thing to do. Accepting that everything happens for a reason, in the way it’s supposed to happen, is hard to accept. This is taking life in stride, which I think our pets do well. Let’s try to learn from them. I like to teach my staff the following seven steps to becoming healthier, more engaged, and present.

1. Learn to breathe

I don’t mean just your standard day-to-day breathing; learn how to completely fill your lungs, and then completely exhale. It is the most restorative free health benefit you can achieve. Close your eyes. Sit and breathe in slowly through your nose and try to completely fill your lungs. Count to ten; this helps. Hold your breath for three, then slowly release it through your lips, counting to ten again. Just one deep breathing cycle will bring you relaxation and clarity. Doing this exercise multiple times can reduce your heart rate, blood pressure and cortisol levels. This is something you can do anytime, anywhere, and at no cost. It works wonders with relieving in-the-moment stress. Once you have mastered breathing, try meditation. I love Headspace; it’s a great meditating app for anyone who wants to learn how to be mindful.How to deep breathe

2. Find a mantra

A mantra is a positive phrase or personal affirmation. It can be something simple like “I’m beautiful” or “I’m healthy”. Write it down and repeat it twice daily in the mirror. What you think about, you bring about. Get an index card and write down your mantra…mine sits on my mirror in the bathroom, so I remember to do it every day.

3. Drink water

Your body is made up of 60% water, and it’s vital to so many processes. It flushes wastes, rebuilds cells, transports proteins, protects the brain, cushions joints, and helps you maintain your body temperature. Drinking water is so important to feeling good.

4. Listen more than you talk

The art of listening can be mastered, but it takes a patient and thoughtful person. Be present when someone else is talking. Focus on his or her words and meaning. Ask questions but don’t interrupt. Stay curious and out of judgment. Don’t offer solutions unless you are asked. Don’t be a one-upper; when you are listening, it’s not about you. Listening skills will open your world to so much information. The more you listen, the more extraordinary coincidences you will notice.

5. Exercise

It can be anything. Maybe you need a guided class or gym membership. Maybe try an online program like OMFIT or GAIA. Or just start walking every day. Walking outdoors gives you the double benefits of exercise and enjoying nature. Aim for one hour of some type of activity per day. Going up and down your stairs at home may count for 20 minutes. Get creative with movement; take a dance class, ride your bike to work, or try yoga.

6. Detox your body

Choose foods that are less processed, and contain less sugar and fewer additives. Try adding fresh fruit and veggies to every meal. Maybe you can adopt one plant-based meal per day. Notice how good you feel after you eat. Paying attention to your body, being present, and noticing how the food makes you feel helps you make wiser choices. Keep a food/feeling diary. Write down what you eat, then how you feel. You will quickly start making wiser choices. If you hate fruits and veggies, try smoothies; blend them all up for a great meal packed with vitamins, minerals and fiber.

7. Focus on others

Veterinary medicine is a service industry. Every day we are given the privilege of making someone’s life better. We are very powerful, but with power comes great responsibility. Noticing what you can do to make a difference for someone else, and then doing it, will ultimately fulfill you. Simply taking a cat carrier out to the car for an elderly client, or finding some toys for the mom with two rambunctious toddlers, can profoundly alter the client’s experience — and yours.  Try focusing on serving others in meaningful ways. It will feel great, I promise. One of my employees waited outside an exam room door while a client said her final goodbyes to her deceased cat. This client lives by herself, and my staff member didn’t want her to walk to her car alone, since every other time she always walked with her cat. I thought this was such a beautiful gesture.

A personal story

Implementing the steps

How do you make these steps a part of everyday life in a busy veterinary hospital? At our practices, I have added a mindfulness component to every session of hospital rounds. Practice owners — if you are not doing this, please start. Close every Wednesday (or pick the day you want) for two hours and do hospital rounds. Focus on your hospital and staff and how you can create a better practice culture for everyone.

It has been three years now since I implemented mindfulness into our hospital rounds. We start each session by meditating. For about two months, our staff thought this was crazy, and then something beautiful happened. They started asking to meditate longer. We use our Headspace app to guide us. They often ask for ten- to 20-minute meditations and it has changed our staff. They now participate in hospital rounds in a different way. They listen more, and are proactive and thoughtful with their conversations.

Along with mindfulness and meditating, we also talk about wellness tips, like those listed above. At one of our rounds, we invited a yoga therapist who took us through some poses to relax us and help us through our day. I have witnessed one of our doctors going through these yoga poses before she enters certain appointments. I asked how it has helped her, and she replied that it allows her to better handle difficult clients.

By picking a topic and incorporating it into each round session, you will empower your staff. The day after we invited a local nutritionist to talk about healthy eating, several staff members started bringing in healthy treats and cutting out sugary coffee. You can accomplish a lot by focusing on one positive change; introduce it, and see how it helps. I believe you will be pleasantly surprised.

When you implement the seven steps presented above, the universe will start to show you positive energy in many ways. Pay attention. Thoughtful breathing will bring you great clarity. Your mantra will build your soul. Drinking water will replenish your vital systems and make you feel good and less tired. Listening will teach you how many connections you can make within the universe — and how many meaningful coincidences occur. Exercise moves the body to clear the mind. Healthy food gives your body the opportunity to process more efficiently, and fuels it with energy. Finally, focusing on others will fill you up with kindness and love.

Western herbs for liver dysfunction in animal patients

Liver health is vital to patient health. Learn how a variety of Western herbs can be used to support liver function in animals.

As holistic veterinary practitioners, we formulate treatment plans to support the body’s innate ability to heal itself, while also addressing the underlying cause of disease and providing symptomatic relief in our animal patients. The liver is the most important organ of metabolism in the body; supporting liver health supports the body’s ability to heal. This article illustrates how Western herbs support the many different functions of the liver.

A brief review

The liver plays a role in detoxifying molecules, including all the environmental toxins the

body is exposed to. Considering there are somewhere between 25,000 and 84,000 chemicals in commerce in the United States, the liver has a heavy workload.1 Many metabolites are lipid soluble; they must be converted into water-soluble substances by the liver’s detoxification pathways in order to optimize removal. The liver processes these metabolites in two main ways:

  1. Phase I involves cytochrome p450 enzymes (CYP450) and improves water solubility. The Phase I CYP450 superfamily of enzymes is the first defense to biotransform xenobiotics, steroid hormones, and pharmaceuticals.2 These initial reactions have the potential to create oxidative damage within cell systems because of the resulting formation of reactive electrophilic species.2 The large CYP2 family of enzymes is involved in the metabolism of drugs, xenobiotics, hormones, and other endogenous compounds.2
  2. Phase II uses conjugation enzymes, Nrf2 signaling, and metallothionein for further biotransformation.2 The collective activity of these enzymes results in an increase in the hydrophilicity of the metabolite, theoretically leading to enhanced excretion in the bile and/or urine.2 Many foods as well as herbs appear to act as both inducers and inhibitors of CYP1 enzymes, an effect which may be dose dependent or altered by the isolation of bioactive compounds derived from food.2 For example, turmeric has been shown in vivo to induce and inhibit CYP1 enzymes.2

What happens in liver disease?

Chronic hepatitis is associated with mixed inflammatory infiltrates and characterized by hepatocellular apoptosis or necrosis, inflammatory infiltrates, regeneration, and fibrosis.3 Mild portal inflammation is seen as a common, nonspecific, reactive change (some internists recommend the pathologist confirms that there is moderate to severe inflammation and necrosis).3 The presence of fibrosis, found through a hepatic biopsy, denotes a more serious consequence.3

Liver cirrhosis is the final phase of all progressive and chronic liver diseases.4 The physiopathology of cirrhosis is determined by multiple factors of varying importance, including oxidative stress, systemic inflammation, and organ dysfunction.4 One of the key elements involved in cirrhosis physiopathology is systemic inflammation, recently described as one of the components in the cirrhosis-associated immune dysfunction syndrome.4 Local injury and inflammation and fibrosis in the liver creates architectural disorganization which impairs bacterial clearance.4  With decreased liver function there is decreased synthesis of innate immune system proteins and pattern recognition receptors that, together, reduce the bactericidal capacity of the cells of the innate immune system.4 As cirrhosis progresses, the gut is affected, in particular the gut-associated lymphoid tissue (GALT), which is the first immunological barrier of defense against antigens and pathogens entering the organism from the intestine. As a consequence of leaky gut, an elevated enteric bacterial load, and changes in intestinal microbiota populations towards pathogenic species, GALT is under the constant pressure of pathological bacterial translocation (BT) and bacterial products translocation.4 Finally, at a systemic level, immune cell function is compromised.4

Based on this very brief review of hepatitis, several classes of herbs should be considered for use (see sidebar) depending upon the needs of the patient. A description of several follows.

  • Taraxacum officinale, commonly known as dandelion, has antioxidant properties found to be protective against hepatotoxicity induced by acetaminophen in mice.5,16 Hepatotoxicity induced by acetaminophen is related to reactive oxygen species (ROS) formation and excessive oxidative stress; dandelion root and leaf were found to contain natural antioxidant compounds that diminish the drug-induced hepatic dysfunction.5,6 Dandelion root was found to prevent the increase of serum aspartate and alanine aminotransferases.7 Other studies have shown that dandelion root, as well as dandelion leaf tea (water extract), reduced liver damage serum markers (ALT, AST, GGT, ALP and LDH) thus indicating the plant extract’s effects in restoring the normal functional ability of the hepatocytes.7,8
  • Herbs to support liver health

    Centella asiatica (gotu kola) contains asiatic acid, which has been shown in studies to be hepatoprotective, anti-inflammatory, antitumor and neuroprotective. It is also an antioxidant, aids in wound healing, improves microcirculation, and heals inflamed intestinal tissue.9 Additionally, gotu kola inhibited liver fibrosis and largely improved liver function in a dose-dependent manner in rats.9 Liver fibrosis represents the final common pathway of virtually all chronic liver diseases. It is characterized by the excessive accumulation of extracellular matrix (ECM) and activated hepatic stellate cells (HSC) that are undergoing myofibroblast transition identified by de novoa-SMA expression.9 Although significant progress has been made in our understanding of hepatic fibrosis, treatment for liver fibrosis remains ineffective.9 Gotu kola shows potential as a useful herbal option for treatment.

  • Andrographis paniculata (green chiretta) is traditionally used for the treatment of the common cold, diarrhea, fever due to infectious causes, jaundice, and cardiovascular health. A health tonic for the liver, it addresses several issues encountered in liver disease due to its antiviral, hepatic anti-inflammatory, antibacterial, antioxidant, hepatoprotective and immunomodulatory properties.10,11 As an immunostimulant, it enhances phagocytic activity.10 As an anti-inflammatory, Andrographis has been found to inhibit COX-2 expression. Energetically, it is a cold and dry plant so is best used to clear the body of heat and to dispel toxins.
  • Urtica dioica, better known as stinging nettle, encompasses many actions that are beneficial for liver disease. The leaf is traditionally used for anemia as it supports red blood cell production and capillary and venous integrity. Improving circulation supports blood flow to the healthy areas of the liver and is vital for the patient’s health. The seeds also have antioxidant and hepatoprotective action.12 From an energetic perspective, nettle is generally cool to neutral and slightly dry.13 It is nutritive, supplies minerals, and has the benefit of being a potassium-sparing diuretic, which can be helpful in cases of advanced liver disease with ascites. Nettle assists other organs, including the kidneys, as a tonic, and it enhances the elimination of uric acid and other metabolic wastes.10 Since leaky gut syndrome and dysbiosis often eventually accompany liver disease, the biofilm inhibition abilities of nettle are also beneficial. Many canine patients will readily drink a tea made with nettle leaf.
  • Ocimum sanctum, also known as holy basil or tulsi, is a sweet and spicy herb that will help calm a patient with liver disease through its adaptogenic actions. As an adaptogen, it helps with cloudy thinking (which plagues humans with liver disease as well as veterinary patients), in addition to enhancing resistance to the emotional and physiological stresses that accompany chronic disease. It is a nootropic, immunomodulator and anti-inflammatory as well an antioxidant. It provides gastro as well as hepatoprotective effects, beneficial for those patients who have diarrhea and other signs of leaky gut with liver disease.14
  • Curcuma longa (turmeric) inhibits hepatic inflammation and upregulates phase II enzymes.15 Beyond its hepatic effects, turmeric stimulates and improves digestion, decreases biofilm production, improves intestinal permeability function, and decreases intestinal inflammation.16,17

Holistic veterinarians address the whole patient and not just the disease. Liver disease in our animal patients is often idiopathic, so it is important to use herbs that are not only hepatoprotective but also exhibit anti-inflammatory and antimicrobial effects, inhibit fibrosis, improve circulation, and protect the gut. A nice generic formulation for liver disease in a patient may include 20% holy basil, 20% gotu kola, 15% Andrographis, 15% dandelion root, 10% turmeric, 10% nettle leaf, 5% licorice and 5% ginger. Herbs are a fantastic choice for veterinarians to use in patients with liver disease, as conventional medicine offers limited treatment options.

References

1“Roundtable on Environmental Health Sciences, Research, and Medicine; Board on Population Health and Public Health Practice; Institute of Medicine. Identifying and Reducing Environmental Health Risks of Chemicals in Our Society: Workshop Summary”. Washington (DC): National Academies Press (US); 2014 Oct 2. 2, The Challenge: Chemicals in Today’s Society. Available from: ncbi.nlm.nih.gov/books/NBK268889/.

2Hodges, Romilly E, and Deanna M Minich. “Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application.” Journal of nutrition and metabolism vol. 2015 (2015): 760689. doi:10.1155/2015/760689.

3Twedt, David. “Chronic Hepatitis — Latest Update in the Dog”. Atlantic Coast Veterinary Conference 2017, vin.com/members/cms/project/defaultadv1.aspx?id=8207613&pid=19448&meta=vin&.

4Dirchwolf M, Ruf AE. “Role of systemic inflammation in cirrhosis: From pathogenesis to prognosis”. World J Hepatol. 2015;7(16):1974–1981. doi:10.4254/wjh.v7.i16.1974.

5Dirleise Colle, Leticia Priscilla Arantes, Priscila Gubert, Sônia Cristina Almeida da Luz, Margareth Linde Athayde, João Batista Teixeira Rocha, and Félix Alexandre Antunes Soares. “Antioxidant Properties of Taraxacum officinale Leaf Extract Are Involved in the Protective Effect Against Hepatotoxicity Induced by Acetaminophen in Mice”. Journal of Medicinal Food 2012 15:6, 549-556.

6Nazari A, Fanaei H, Dehpour AR, Hassanzadeh G, Jafari M, Salehi M, Mohammadi M. “Chemical composition and hepatoprotective activity of ethanolic root extract of Taraxacum Syriacum Boiss against acetaminophen intoxication in rats”. Bratisl Lek Listy. 2015;116(1):41-6.

7Mahesh A, Jeyachandran R, Cindrella L, Thangadurai D, Veerapur VP, Muralidhara Rao D. “Hepatocurative potential of sesquiterpene lactones of Taraxacum officinale on carbon tetrachloride induced liver toxicity in mice”. Acta Biol Hung. 2010 Jun;61(2):175-90.

8Abdulrahman L. Al-Malki , Mohamed Kamel Abo-Golayel1, Gamal Abo-Elnaga and Hassan Al-Beshri. “Hepatoprotective effect of dandelion (Taraxacum officinale) against induced chronic liver cirrhosis”. Journal of Medicinal Plants Research 2013; 7(20): 1494-1505.

9Li-xia Tang, et al. “Asiatic Acid Inhibits Liver Fibrosis by Blocking TGF-beta/Smad Signaling In Vivo and In Vitro”. PLoS One. 2012;7(2):e31350. doi: 10.1371/journal.pone.0031350.

10David Winston. Herbal Studies Course 2014-2016. Notes.

11Md. Sanower Hossain, Zannat Urbi, Abubakar Sule, K.M. Hafizur Rahman. “Andrographis paniculata (Burm.f.) Wall. Ex Nees: A Review of Ethnobotany, Phytochemistry, and Pharmacology”. 2014. Article ID 274905, 28 pages http://dx.doi.org/10.1155/2014/274905.

12Yener Z, Celik I, Ilhan F, Bal R. “Effects of Urtica dioica L. seed on lipid peroxidation, antioxidants and liver pathology in aflatoxin induced tissue injury in rats”. 2009. Food Chem Toxicol. 47(2):418-24.

13CIVT Veterinary Western Herbal Medicine, Graduate Diploma Class. 2015 Topic Notes.

14Kamyab, A.A., Eshraghian, A. “Anti-Inflammatory, Gastrointestinal and Hepatoprotective Effects of Ocimum sanctum Linn: An Ancient Remedy With New Application”, Inflamm Allergy Drug Targets, 2013 De;12(6):378-84.

15Reuland DJ, Khademi S, Castle CJ, Irwin DC, McCord JM, Miller BF, Hamilton KL. “Upregulation of phase II enzymes through phytochemical activation of Nrf2 protects cardiomyocytes against oxidant stress”. Free Radic Biol Med. 2013 Mar; 56:102-11. Doi: 10.1016/j.freeradbiomed. 2012.11.016. Epub 2012 Nov 30.

16Ghosh SS, He H, Wang J, Korzun W, Yannie PJ, Ghosh S. “Intestine-specific expression of human chimeric intestinal alkaline phosphatase attenuates Western diet-induced barrier dysfunction and glucose intolerance”. Physiol Rep. 2018 Jul;6(14):e13790. doi: 10.14814/phy2.13790.

17Ghosh SS, Bie J, Wang J, Ghosh S. “Oral supplementation with non-absorbable antibiotics or curcumin attenuates western diet-induced atherosclerosis and glucose intolerance in LDLR/mice — role of intestinal permeability and macrophage activation”. PLoS One 9: e108577, 2014. doi:10.1371/journal.pone.0108577.

Helping your clients understand pet food labels

Tips to help veterinarians be the trusted resource for pet dietary advice and empower clients to realize the importance of understanding pet food labels.

Many of today’s pet parents strive to be well-educated about pet foods. They trust their veterinarians to tell them what food to give their animals, only to leave the clinic, bag in hand, dismayed at why the veterinarian would recommend a food with such horrific-sounding ingredients. Others have come to believe they can decide for themselves what foods to give their pets; some are incredibly knowledgeable while some think the choice is as simple as checking the label for high protein or low fat. Few realize how complex, misleading, and deceptive pet food packaging can be, and that it often lacks both simplicity and transparency. Support your clients’ goals by using your education and resources to help them choose wisely and better understand pet food labels, and to turn to you for dietary advice.

Everyone Googles

The information Google provides depends, of course, on the specific question asked. An internet search of “top pet foods” recommended by veterinarians lists Hill’s Science Diet, Royal Canin, and Purina Pro Plan. By changing the search parameters to the “top healthiest pet foods”, Ollie’s Healthy Turkey Fare, Pet Plate Chompin’ Chicken, and Fromm Gold head the list. Why such a discrepancy in opinion?

Playing detective to decode the truth

Many veterinarians rely on the manufacturers of prescription diets, and believe that the minimums and maximums of protein, fat, fiber and moisture are all they need to know to recommend a quality food. The analysis panel can be very misleading, and while macronutrients are listed, carbohydrates are not included and must be calculated. Yet, when we read the ingredient lists of most dry kibble, it is obvious that starches are always included. Nutritionists know the devil is in the details, but one must play detective to decipher the truth.

Digestibility, quality and safety 

The three crucial parameters of digestibility, quality and safety cannot be easily determined by reading pet food bags. Remind your clients that it’s not just what their dogs or cats eat, but rather what they absorb, that’s most crucial to good health. This point was recently driven home to us by the ongoing investigations into spikes of canine dilated cardiomyopathy cases. Many of the diets that were tested were found to contain taurine, methionine and cysteine levels consistent with AAFCO recommendations, yet many dogs consuming those same diets lacked adequate taurine in their blood.1

A large number of clients understand that digestibility is important and that high protein content is not enough. (Leather meal, animal hide, is very high in protein, but completely indigestible.)  The higher the moisture content, the lower the protein content will appear, but this protein may be of much higher quality than in a food whose analysis panel states a higher protein percentage. The guaranteed analysis protein percent is actually an archaic measure of nitrogen, a relic from the livestock feed industry, and not a measure of quality meat protein at all. Nitrogen can also come from plants. It can even come from toxic melamine; we have learned that unscrupulous manufacturers can artificially elevate “protein” levels in their foods to mislead consumers, and that pets can die from this hidden ingredient.

What is AAFCO and what does it mean to clients?

AAFCO is the Association of American Feed Control Officials, an industry organization. Consumers have been trained to believe that a pet food is complete and balanced for all life stages if the bag states: “This food meets or exceeds AAFCO nutrient profiles and is suitable for all life stages.” Indeed, “exceeding” is not necessarily okay and “meeting” may still be inadequate. AAFCO admits: “It is impossible that any list of concentrations can invariably ensure that all nutrient requirements are fulfilled in all diet formulas without additional considerations.”2 non-veterinary diets

Despite this admission of inadequate guidelines, they are currently all we have to rely on when we analyze a package of pet food. Pet parents view the AAFCO designation as the meeting of a nutritional standard.  So it is important, at minimum, to understand the AAFCO terminology.

Ingredient order and definitions –deciphering the facts

Always look at the back of the bag or the side of the box for the full ingredient profile, listed in order of weight. Don’t rely on a cursory list of ingredients on the front of the bag next to the splashy photographs of fresh meat, fruits and vegetables.

  • Ideally, we want to see a specific meat, such as pork or beef, listed first. If it is, this means it has been weighed with the water still in it. This makes it heavier and brings it to the top of the list. It refers to clean flesh from slaughtered animals. However, the water is removed during processing, meaning there is less weight of actual meat-derived protein in the end product.
  • By-products are non-rendered and come from slaughtered animals. They include organs, fat and entrails, but no hair, horns, teeth or hooves. By-products can be healthy, but we don’t know the quality based on a label listing. Carnivores do need to ingest organs for good health.3
  • A meat “meal” means the tissue has been rendered. This process converts waste animal tissue (not human grade meat) into stable usable materials like yellow grease, choice white grease, bleachable fancy tallow, and a protein meal such as meat and bone meal or poultry by-product meal.3 It contains no hair, hoof, hide or extraneous materials. By definition, while up to 9% of the crude protein in the product may be pepsin indigestible, the product would be more protein-dense than its clean flesh counterpart weighed with water included.
  • If a meat product is followed by more than one grain or starch, there may be more grain or starch than meat by weight, even though the meat is listed first. A common marketing trick is to list a grain, for example corn, broken down into corn gluten, corn starch, corn middlings, etc. This puts the corn versions below the meat source — unless you add them all together. This is called ingredient splitting.4 Corn is used to fatten livestock. Why? Corn is starchy. Starch is a carbohydrate or sugar. The body stores excess carbohydrate in the form of triglycerides, which are fat. In other words, fat is the storage form of excess carbs. Carbs make you gain weight, not fat! Corn is not a natural food for a carnivore diet.5

Sadly, American corn is contaminated with mold and aflatoxins, which are potentially carcinogenic. Most corn is GMO unless stated otherwise, which means it won’t die when the fields are sprayed with glyphosate herbicide to kill the weeds. But the corn does incorporate the glyphosate into its cells. The cattle eat the corn, and the glyphosate becomes incorporated into the food web. Humans, livestock and pets ingest the contaminated corn and/or the contaminated meat.6

  • After the starches on a label, a fat is listed along with how it is preserved (i.e. with mixed tocopherols, a source of vitamin E and/or rosemary extract). Avoid animal fat preserved with BHA, BHT or ethoxyquin. These artificial preservatives have been shown to be carcinogenic in rats7; in fact, ethoxyquin is banned in Europe, Australia and New Zealand.8
  • Avoid added sugars such as corn syrup, molasses, beet sugar and maple syrup. These are not useful nutrients. They entice a pet to eat the food and to become addicted to it. Why? So your client keeps purchasing it! Just because a pet likes it, does not mean it is good for him.
  • Salt should not be too high on the list, but this is often the case with canned foods. Salt is also addictive. It is very difficult to get a cat off an addictive canned diet; it often takes a 21-day program. Taste buds will adjust, however, so tell your clients to be patient.
  • If vitamins and minerals are added, look for those that are chelated, which improves absorption (listed as a chelate or a proteinate). However, do be aware that this chelation is not “natural” and often occurs by combining a mineral with soy proteinate, which is most assuredly GMO.9 Remember that GMO seeds result in crops laden with pesticides, allowing a mechanism for these chemicals to be incorporated into our patients’ (and our own) gut microflora.10 The best pet foods contain enough whole food sources of vitamins and minerals that synthetic versions need not be added.
  • Avoid canned foods that contain carrageenan as a “natural” thickener. This ingredient has been used in studies to intentionally stimulate inflammatory bowel disease.11 And we wonder why so many cats vomit?
  • JAVMA published a report showing an association between canned diets and hyperthyroidism in felines.12 We now know that can liners may contain BPA, a known endocrine disruptor.13 If a food contains dye (i.e. red dye 40), put it back on the shelf! Some grocery store foods, many treats, and dental chews still contain dye. Artificial colorings can be carcinogenic.14 Better ingredients can be utilized. For example, many pet parents know that blue-green algae can provide great antioxidant properties, while giving a beautiful green color to dental chews!
  • Small amounts of the best, healthiest, and most expensive ingredients are usually last on the list! These look like real foods. You may see blueberries, cranberries, broccoli, dried kelp, hemp seed and others. Some foods, like chicory root extract, are prebiotics that promote gut flora health. Prebiotics feed probiotics, the good bacteria in the gut. You may also see prebiotics listed on the label as inulin, which can come from chicory root.15 Added probiotics may not be as viable as those you add to the food yourself when serving it, but I applaud company attempts to include them, although paying more for them may be a waste of money. Probiotics will have names like Lactobacillus acidophilus and Bifidobacteria.

Allergens and contaminants

Chicken is overused as a protein in the pet food industry, and is the most stressed livestock source of protein. Beef is often considered a common allergen, especially for cats.16 Wheat and soy have long been regarded by many veterinarians as common allergens.17 Today, most soy is of genetically modified origin, which is now being linked to cancer due to its connection to glyphosate.18

Based on my observations, gluten-free rice may be a better choice for many pets than other grains. However, the processing and high starch content are still not ideal. There have also been concerns about the presence of arsenic in rice.19 Some GI signs initially improve or even resolve, only to recur with repetitive use. Millet is a more easily digested grain, but is also a source of starch.20

Grain-free marketing trick 

Don’t be fooled by “grain-free” diets. It doesn’t mean they’re starch-free. The grain is commonly replaced by starchy potato, tapioca or legumes such as chickpeas. To make kibble, there must be a starch source, and processed carbohydrates create inflammation.21 Starch is “dampening” according to TCVM philosophy.

Grain-free” diets may or may not be higher in protein. While clients have been misled to believe these diets contain more meat protein, this is not necessarily true. Meat is a complete source of protein and absorbable amino acids that are critical to good health.

Many pets suffering from allergic dermatitis or inflammatory bowel disease do improve on unique protein and unique carbohydrate diets, while others don’t. Improvement is often short-lived, simply due to a change in nutrients. But don’t make the mistake of shifting a pet who has improved on a grain-free diet back to a grain diet; rather, shift toward a fresh, species-appropriate, balanced raw diet.

Cancer and obesity

One out of two pets is now dying of cancer. Some seemingly innocuous ingredients may be detrimental, and foods that contain corn, soy, and excessive sugar sources may be partially to blame for the cancer and obesity epidemic.18

Dry kibble and canned foods are processed at high temperatures. Cooked starch produces carcinogenic acrylamides22 and cooked meats produce mutagenic heterocyclic amines.23 Sugar (glucose) fuels cancer cells.24 Dr. Thomas Seyfried’s metabolic management of chronic disease research, as well as research by Ketopet Sanctuary, have become the subject of discussion among many pet cancer Facebook groups. Just a few more reasons why our educated pet parents are avoiding processed foods and flocking to fresh, species-appropriate raw diets.

Concluding thoughts

There is a great deal of confusion around pet food label terminology. In the end, my opinion is that it doesn’t matter, because it all pertains to processed food, which is woefully inadequate. But I also realize that society demands kibble and canned foods be available for dogs and cats, so there will always be some who need to feed these diets. It is disappointing that manufacturers have been known to lie on their labels. Some have claimed to use human grade ingredients, yet pentobarbital from euthanized animals was discovered in their foods.25

Information is powerful. If you empower your clients to be intelligent pet food consumers, they will bond with you. They will appreciate your holistic recommendations of a species-appropriate diet with whole food vitamin supplementation, glandulars, medicinal Western and Chinese herbals, or even natural essential oils for wellness and therapy.

Today’s consumers are purchasing more and more natural options for themselves and their pets, and are questioning old-fashioned conventional recommendations for pet care. Savvy pet parents are seeking veterinarians who know what is trending. They want to believe that their veterinarians are knowledgeable and have their pets’ best interests in mind at all times. Make sure your own advice is in sync with current progressive natural diet expertise. Educated pet parents make better food choices for their pets, and will also respect, trust and appreciate your other integrative suggestions if you are on the same page with them and their move toward quality natural nutrition.

References

1fda.gov/animal-veterinary/news-events/fda-investigation-potential-link-between-certain-diets-and-canine-dilated-cardiomyopathy

2fda.gov/animal-veterinary/animal-health-literacy/pet-food-labels-general#Ingredient

3aafco.org/Consumers/What-is-in-Pet-Food

4dogfoodadvisor.com/dog-food-industry-exposed/ingredient-splitting/

5scielo.br/scielo.php?script=sci_arttext&pid=S0103-84782016001202189

6integrativesystems.org/systems-biology-of-gmos/

7livescience.com/36424-food-additive-bha-butylated-hydroxyanisole.html

8 google.com/amp/s/observer.com/2015/05/the-grossest-substances-still-used-in-paneras-food/amp/

9natureslogic.blogspot.com/2013/04/what-about-gmos-and-protein.html

10academia.edu/7443850/Glyphosates Suppression_of_Cytochrome_P450_Enzymes_and_Amino_Acid_Biosynthesis_by_the_Gut_Microbiome_Pathways_to_Modern_Diseases 

11ncbi.nlm.nih.gov/pmc/articles/PMC1242073/

12avmajournals.avma.org/doi/abs/10.2460/javma.2004.224.879

13med.stanford.edu/news/all-news/2016/06/link-between-canned-food-exposure-to-hormone-disrupting-chemical.html

14healthline.com/health/food-nutrition/is-red-dye-40-toxic#2

15prebiotic.ca/chicory_root.html

16npr.org/sections/health-shots/2011/08/10/139386917/organic-poultry-farms-have-fewer-drug-resistant-bacteria-study-finds

17veterinarymedicine.dvm360.com/diagnosing-food-allergies-dogs-and-cats-bring-your-case-trial

18naturalsociety.com/study-gmo-soy-accumulates-cancer-causing-formaldehyde/

19glutenfreedietitian.com/gluten-free-diet-arsenic-and-rice/

20thekitchn.com/good-grains-what-is-millet-67713

21todaysdietitian.com/newarchives/110211p36.shtml

22ncbi.nlm.nih.gov/pmc/articles/PMC6163171/

23ncbi.nlm.nih.gov/pmc/articles/PMC2769029/

24bc.edu/sites/libraries/facpub/seyfried-cancer/book.pdf

25fda.gov/animal-veterinary/news-events/fda-alerts-pet-owners-about-potential-pentobarbital-contamination-canned-dog-food-manufactured-jm

VetCell Therapeutics USA gets approved for clinical trial of DentaHeal Cell Therapy for FCGS

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Conducted in collaboration with researchers from the UC Davis School of Veterinary Medicine, this is the first country-wide clinical trial to evaluate the safety, efficacy and potency of VetCell Therapeutics’ feline allogeneic MSC therapy for treating FCGS.

VetCell Therapeutics USA™, a clinical-stage, pet-focused cell therapy division of PrimeGen US Inc., announced last week that it has received authorization from the U.S. Food and Drug Administration (FDA) to begin a multi-centered, country-wide clinical trial to evaluate the safety, effectiveness and potency of DentaHeal™, its investigational cell therapy product, for the control of clinical signs related to feline chronic gingivostomatitis (FCGS). The 200-cat trial will focus solely on treating patients with FCGS that have not responded to full- or partial-mouth extractions and medical therapy.

This authorization represents a major milestone for VetCell Therapeutics USA, as it can now treat feline patients suffering from FCGS with DentaHeal. DentaHeal is an allogeneic, adipose-derived, mesenchymal stem cell treatment. This minimally invasive, intravenously administered cell therapy may help to correct immune abnormalities associated with FCGS in cats.

This novel therapy was developed at the UC Davis School of Veterinary Medicine, where Dr. Boaz Arzi, DVM, DAVDC, DEVDC, FF-AVDC-OMFS led a successful clinical trial of an investigational MSC product. That pilot study provided the foundation for a patent, which VetCell Therapeutics USA acquired in order to pursue FDA approval for its DentaHeal cell therapy.

Approximately 30 percent of FCGS patients do not respond to standard treatments and require life-long pain medication, antibiotics and immunosuppressive drugs. Sadly, the cats that do not improve, even with implementation of improved dental hygiene, medicines, and oral surgery, are often euthanized.

“FCGS is a terribly debilitating, immune-mediated disease and sadly, the outlook for cats that do not respond to available treatments is bleak,” said Dr. Chad B. Maki DVM, Chief Veterinary Medical Officer, VetCell Therapeutics USA. “Our vision is that DentaHeal will dramatically improve the quality of life for cats with FCGS by completely resolving or substantially improving their condition and provide them with long-term remission and relief.”

Currently, there is no FDA-approved cell therapy product for treating FCGS. The intent of this investigational trial is to evaluate DentaHeal as an innovative, drug-free treatment for FCGS. Led by principal investigator Dr. Boaz Arzi, up to 200 cats will be enrolled based on the protocol eligibility criteria as assessed by experienced board-certified veterinarians. This trial will be conducted in collaboration with UC Davis’ Veterinary Institute for Regenerative Cures (VIRC).

“This is a massive milestone for VetCell Therapeutics USA. Our dedicated and passionate team has worked tirelessly to advance to the clinical stage, and I believe the work being put into R&D and clinical trials will position VetCell as the catalyst for cell therapy becoming a mainstay of veterinary medicine,” said Tom C.K. Yuen, founder and chairman of PrimeGen Global, the parent company of VetCell Therapeutics USA.

VetCell Therapeutics USA plans to start recruitment for this clinical trial this month. The FDA has authorized VetCell Therapeutics USA to recover the direct costs from a pet owner for the manufacturing (e.g.: raw materials, labor and non-reusable supplies and equipment) and shipping and handling of two-dose treatments of DentaHeal.

To learn more about the FCGS stem cell trial, visit www.vetcelltherapeuticsusa.com/FCGS_Trial.

The Dog Aging Project – 80,000 dogs and counting

A longitudinal study that aims to determine the biological, lifestyle, and environmental factors that influence healthy aging in dogs, the Dog Aging Project is expected to spearhead advances in veterinary clinical practice.

“Should I change my dog’s food?” “What about probiotics?” “What can I give my dog for her coat?” As veterinary professionals, we are often asked for advice about diet, supplements, exercise regimes, and other factors that influence overall health. Veterinary medicine is quite robust when it comes to diagnosing and treating illness, but when it comes to proactive maintenance of ideal health, there is a distinct lack of evidence-based research upon which to base our recommendations. The research currently underway at the Dog Aging Project intends to close that gap.

Dog Aging Project logo

The Dog Aging Project is an innovative initiative that brings together a community of dogs, dog owners, veterinarians, researchers and volunteers to carry out the most ambitious study of dog health in the world. Funded by a U19 grant from the National Institute on Aging, a part of the National Institutes of Health, the Dog Aging Project is a longitudinal study modeled after ongoing human longitudinal studies such as the Framingham Heart Study and the Baltimore Longitudinal Study of Aging. The Dog Aging Project has three primary research aims: define aging, explain aging, and intervene in aging.

Why study aging? 

In a clinical setting, veterinary professionals often treat patients with chronic disease and multiple comorbidities. While there are tools to diagnose and treat many of these conditions, prevention would be the gold standard and is a key focus of integrative approaches to veterinary medicine. In humans, the single greatest risk factor for the development of many of these diseases, including the major causes of mortality in developed nations, is aging.1 This is likely true for dogs as well. The Dog Aging Project is focused on understanding how biology, lifestyle and environment interact to influence healthy aging, with the goal of intervening to increase healthspan — the period of life spent free of disease. Ultimately, healthy aging requires the maintenance of independent physical function, cognitive ability, mental health, and general well-being.2

Why study dogs? 

Geroscience has made huge advances in the last few decades, but most of these studies have been conducted in laboratory settings with short-lived model organisms such as yeast, fruit flies, nematodes and mice. Several studies of health and aging have been conducted in companion dogs by researchers in our group and elsewhere,3,4,5,6 but only the Golden Retriever Lifetime Study (GRLS) combined a large-scale longitudinal study with clinical and genetic data for each dog.7 The Dog Aging Project is working closely with, and expanding on, the breed-specific work by GRLS. By enrolling tens of thousands of both purebred and mixed breed dogs, the dataset we are building will encompass the full range of canine genetic and phenotypic diversity, including variation in size, shape, behavior, life expectancy, and age-related disease.8 Not only does this research have the potential to directly advance canine health; it also has the potential to inform human medical research as well.

A novel veterinary research framework

The Dog Aging Project is a citizen science endeavor, which depends on the active participation of dog owners who both nominate their dogs for the project and collect data on their dogs throughout their lifetimes. All dogs are welcome — young and old, purebred and mixed breed, intact and sterilized, healthy dogs and those with chronic illnesses. Currently, dog owners from all around the US, and from a range of socioeconomic and cultural backgrounds, have nominated their dogs for the project.

Our participants are invited to establish a secure personal portal at the Dog Aging Project and complete the Health and Life Experience Survey, an extensive questionnaire that collects detailed information about each dog’s lifestyle, home environment, and health history. Using a sophisticated cohort design, subsets of dog owners will be invited to participate in other activities as detailed below.

The massive dataset generated by the Dog Aging Project will be made available to researchers around the world in a privacy-protected, open data model in order to maximize the project’s impact on the advancement of dog health. This complex project is supported by a highly interdisciplinary team from research institutions around the world who have partnered with veterinary teaching hospitals across the US. This collaboration will enable the Dog Aging Project to meet its three primary research aims.

Defining aging in dogs

 In humans, standardized clinical metrics quantify aging; for example, the Grip Test or Chair Stand. These are largely absent in veterinary medicine. Both dog owners and their veterinary health team members know that some dogs seem to age more healthfully than others. Some 12-year-old dogs play like puppies, while others experience the phenomenon of “frailty,” displaying reduced energy, declining cognition, and limited mobility. Unlike human medicine, there are no clearly defined metrics to determine how well or how poorly a dog is aging.

In order to define aging in dogs, the Dog Aging Project is developing a rigorous, reproducible and practical Canine Fragility Score, which will be based on familiar tools and measurements (body weight, body condition score, activity monitor collars), existing scoring systems (Canine Cognitive Dysfunction Rating Score,9 Health-Related Quality of Life Instrument10) and novel metrics (gait speed and stair climb). Given the extreme variation in size, activity level, temperament, environment, and disease susceptibilities among dogs, the key to defining aging will involve measuring the change in an individual’s metrics over time, hence the value of a long-term study like the Dog Aging Project.

In addition, researchers in our group are documenting and describing the multimorbidity states of companion dogs.11,12 We will use this data to predict the likelihood that an aging dog with one diagnosis will develop a second within a given timespan. These data will be used to develop a Canine Multimorbidity Index to be used in the clinical management of aging dogs. Both this index and the Canine Fragility Score will be made available to clinicians to be used as a benchmark of canine health and to indicate the most valuable targets for intervention.

Explaining aging in dogs

This research aim will be accomplished by discovering the genetic and environmental factors that influence aging and by identifying intermediate molecular traits through which their influence unfolds. Ten thousand dogs will be selected from among all Dog Aging Project participants to receive a saliva swab kit. This kit will be utilized to capture genomic information about these dogs. Our team will integrate health measures and behavioral traits with genome sequence data and carry out comprehensive genome-wide association studies.

In addition, 1,500 participants from whom we have collected genomic information will partner with their primary care veterinarians to provide blood and fecal samples. The team at the Dog Aging Project will use a systems biology approach to quantify the metabolome (total number of metabolites), the microbiome (gut microfauna), and the epigenome (chemical compounds and proteins that regulate transcription) in this subset of dogs. Our team will use the data to identify molecular biological predictors of disease and longevity, and develop an epigenetic clock that predicts biological age in dogs.

80,000 dogs and counting

Response to the official launch of the Dog Aging Project in November 2019 has been astounding. As of January 2020, over 80,000 dog owners have nominated their dogs for this research. Data collection has already begun. This comprehensive multimodal approach will allow us to determine the biological, lifestyle, and environmental factors that influence healthy aging in dogs, which we are confident will lead to advances in veterinary clinical practice and pave the way for advances in human geroscience as well.

For more information, visit dogagingproject.org.

References

1Kaeberlein M, et al. “Healthy aging: The ultimate preventative medicine”. Science 2015; 350(6265):1191-1193.

2Rowe JW, Kahn RL. “Successful Aging 2.0: Conceptual Expansions for the 21st Century”. J Gerontol B Psychol Sci Soc Sci. 2015; 70(4):593-596.

3Fleming JM, et al. “Mortality in North American dogs from 1984 to 2004: an investigation into age-, size-, and breed-related causes of death.” J Vet Intern Med. 2011; 25(2):187-198.

4Hoffman J, et al. “The companion dog as a model for human aging and mortality.” Aging Cell. 2018.

5Bonnett BN, et al. “Age patterns of disease and death in insured Swedish dogs, cats and horses”. J Comp Pathol. 2010; 142 Suppl 1:S33-38.

6Hoffman JM, et al. “Reproductive capability is associated with lifespan and cause of death in companion dogs”. PLoS One. 2013; 8(4):e61082.

7Guy MK, et al. “The Golden Retriever Lifetime Study: establishing an observational cohort study with translational relevance for human health”. Philos Trans Royal Soc London Series B, Biol Sci. 2015; 370(1673).

8Fleming JM, et al. “Mortality in North American dogs from 1984 to 2004: an investigation into age-, size-, and breed-related causes of death”. J Vet Intern Med. 2011;25(2):187-198.

9Salvin HE, et al. “The canine cognitive dysfunction rating scale (CCDR): A data-driven and ecologically relevant assessment tool”. Vet J. 2011; 188(3):331-336.

10Reid J, et al. “Development, validation and reliability of a web-based questionnaire to measure health-related quality of life in dogs”. J Small Anim Pract. 2013; 54(5):227-233.

11Hoffman J, et al. “The companion dog as a model for human aging and mortality”. Aging Cell. 2018.

12Jin K, et al. “Multiple morbidities in companion dogs: a novel model for investigating age-related disease”. Pathobiol Aging & Age Related Dis. 2016; 6.

13Halloran J, et al. “Chronic inhibition of mammalian target of rapamycin by rapamycin modulates cognitive and non-cognitive components of behavior throughout lifespan in mice”. Neuroscience. 2012; 223:102-113.

14Miller RA, et al. “Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction”. Aging Cell. 2014;13(3):468-477.

15Urfer SR, et al. “A randomized controlled trial to establish effects of short-term rapamycin treatment in 24 middle-aged companion dogs”. Geroscience. 2017; 39(2):117-127.

 

Demystifying hemp and CBD in the equine

Hemp is a buzzword for many reasons. We clear up the confusion surrounding the different types of hemp products available for horses.

Hemp is all the buzz these days, and for good reason. It’s a plant with literally thousands of uses. Hemp is used for clothing, fuel, paper, and everything in between. It is a weed and capable of growing in many different conditions with little additional fertilizer or other inputs. Hemp is nutritious and can have medicinal properties. This article will help clear up the confusion about the different types of hemp products available to horses.

Definitions  

First, a few definitions to clear up the confusion between the different uses and types of hemp:

  • Hemp is known by the Latin names Cannabis sativa or Cannabis indica. There isn’t a clear botanical differentiation between the two species, despite some claims otherwise. Hemp is a cannabis plant that contains no detectable level of THC (tetrahydrocannabinol), the ingredient that can make the animal “high”.
  • Marijuana is the same basic plant but does contain THC and can make the animal “high”.
  • Cannabinoids are the medicinal compounds shown to be medically useful for many conditions. These are found only in the leaves and buds of the plant. The acronym “CBD” is commonly used for medicinal preparations, but in reality, there are over 100 different cannabinoids in a hemp plant. Active compounds called terpenes work synergistically with CBDs.
  • Endocannabinoid system is the receptor system for cannabinoids found in all mammals and in most body systems.
  • Omega 3 and 6 fatty acids are found only in the seeds of the plant. Omega 3 is an essential fatty acid that cannot be made in the body, so needs to be ingested.
  • Industrial hemp is generally grown for its fiber (stems) and seeds. The plants are grown close to each other to promote tall, stemmy, fibrous plants with lots of seeds. Industrial hemp contains very little, if any, CBD.
  • Medicinal hemp is grown to enhance leaf and bud growth, with high levels of CBD and no Omega 3 or 6 fatty acids.
  • Bio-accumulator is a term used for plants – of which hemp is one – that takes up the contaminants and toxins in the soil in which it grows. So when feeding hemp in any form, it’s important to use organically-grown hemp.

Important note!Hemp CBD

Hemp buds and flowers with a high content of cannabinoids (CBDs) are among the most interesting new herbal medicines to come on the market. The medicinal properties of CBDs in animals, especially horses, are just beginning to be explored. Several years of clinical observations and data indicate that horses are very responsive to CBD, in ways that are similar to other species, including humans.

Hemp seeds

Hemp seeds are the most nutritious part of the plant used as food. They contain about 20% protein, 6% carbohydrates, and about 73% healthy fats. They also have significant amounts of calcium, magnesium, manganese, phosphorus, potassium, zinc, and vitamins A and E. Most diets contain an excess of Omega 6 (inflammatory), but hemp contains a healthy balance of Omega 6 to Omega-3 linoleic acid (an anti-inflammatory compound). Feeding hemp oil is a great way to give horses these benefits (be sure to keep it refrigerated in warm weather).

Hemp oil from seeds also contains the Omega 6 fatty acid, gamma- linolenic acid (GLA), a compound not frequently found in food. It offers excellent anti-inflammatory properties, cancer-fighting immune support, and support for insulin resistance (IR).

Hemp protein is highly bioavailable, although it is not a complete protein for replacing all other sources. One ounce of seed contains 9.2 g of protein. Hemp seeds and the protein that comes from their processing are now available; they are a fabulous way to give horses protein without feeding them genetically-modified corn and soybean.

The hemp leaf is an excellent source of fiber, magnesium, calcium and phosphorus. It also contains antioxidant polyphenols to help protect cells from free radical damage, as well as more beneficial chemical compounds such as flavonoids.

Separating the nutritional properties of hemp from its medicinal ones can be complex, since many nutritional compounds are good for horses because they enhance health.

Cannabinoids

Cannabinoids are compounds that come from either endogenous sources (endocannabinoids) or herbal sources (phytocannabinoids). Medicinal hemp contains over 100 different phytocannabinoids in varying concentrations. Some of the cannabinoids present in smaller amounts include cannabigerol (CBG), cannabichromene (CBC), cannabidivarin (CBDV), and tetrahydrocannabivarin (THCV). Hemp contains many other compounds important to the body’s regulatory pathways, such as terpenes and flavonoids. Plants like hops, flax and Echinacea share some of these compounds.

The endocannabinoid system

The endocannabinoid system in vertebrate animals is thought to have been in existence for over 500 million years. All mammals have receptors in most of their internal organs for the cannabinoids found in hemp. These are important in the regulation of many body functions.

Endocannabinoids are compounds released internally in the nervous system to bind to receptors and transmit information. There are two main types of receptors that occur in different tissues, CB1 and CB2. The CB1s are primary in the central nervous system with some in the external organs, while the CB2s are mostly in the immune system, in B cells and natural killer cells, with some in the spleen and tonsils. The complex interactions between the cannabinoids, the immune system, and the inflammatory pathways create a vast array of biochemical functions affected by those cannabinoids.

Very little endocannabinoid research has been done on domestic animals, horses included. Because the endocannabinoid system is present in all mammals, phytocannabinoids have the potential to affect the health of any internal organ with endocannabinoid receptors. For example, the gut, liver and brain all contain receptors for CBDs.

Feeding cannabinoids to horses

Hemp can be fed as a supplement in a variety of ways. The most common form available is an oil extract. It can become quite costly for horses but works great for small animals. Hemp can be fed to horses in the more economical form of powdered biomass or pellets (which may contain a filler). The amount to feed ranges from about 25 mg to 50 mg twice a day. Sensitive horses need a much lower amount, and it’s always a good idea to use less to begin with.

Products contain variable amounts of CBDs and often do not have full analyses, so actual doses may vary greatly from product to product. The hemp industry is not yet regulated, so there are many companies with questionable quality control. All products fed to animals should have a Certificate of Analysis (COA) available on the company website.

Clinical effects in equines

Taking the lead from the small animal and human studies, CBD products have shown positive effects for a number of equine conditions.

  • Issues that center around pain are common in horses. Cannabinoids have action in both acute and chronic pain by modulating pain signals in the central and peripheral nervous systems and acting similarly to an anti-inflammatory.
  • Laminitis is very painful and can be helped with cannabinoids. CBDs can have a positive effect on the metabolic pathways often compromised in insulin-resistant horses.
  • Musculoskeletal pain in the form of various arthritis conditions is responsive to CBDs, with many horses back to performance and remaining sound. This is true for old horses as well as young performance horses.
  • Cannabinoids cross into the brain and can be helpful for horses that have experienced trauma, mental and physical. Human research has shown success with post traumatic stress disorder (PTSD). Similar symptoms are common in horses and in many cases the response to CBD has been dramatic. However, it is not the cure for every horse with mental issues.
  • Cannabinoids have potential benefits for most body parts, reducing inflammation and behaving as an antioxidant. Inflammation is now considered one of the leading causes behind many chronic diseases, from skin disease to arthritis.
  • The immune system is another area where CBDs are helpful. They have a direct effect on many of the complex immune pathways in the gut (where a large portion of the immune system resides). They also directly affect the cells of the immune system.
  • Lyme disease is a serious chronic problem in horses around the country, and especially on the east coast. Lyme suppresses the immune system, causes pain and inflammation, affects temperament, and causes many more and varied symptoms. Cannabinoids are beneficial as a major part of treating Lyme disease in this author’s practice.
  • The eye is another area where CBDs have an affinity, with some human data to back up their use. Horses with uveitis and chronic ulcers respond well to CBDs as a part of their treatment.

Conclusion

Hippocrates once stated: “Let food be thy medicine and medicine be thy food.” In the case of hemp, it’s very true! Hemp in all its forms is a worthwhile addition to a horse’s diet.